We have all seen cases of hyphema, bleeding in the anterior chamber of the eye, due to trauma. In many cases, if the hyphema is small (usually described in terms of a percent of the AC), we can let it resolve with time. The anterior chamber turns over about 1% per minute, so in less than 2 hours there is a complete turn-over. For a small hyphema, it should resolve in a few days to perhaps a couple of weeks. However for a large hyphema with dense clots of blood, there may not be sufficient resolution without an invasive procedure. We can take the patient back to the operating room and completely clear it out or we can also mostly remove the blood at the slit lamp microscope in our clinic. This video covers both techniques which I’m sure you will find useful.
Is it a good idea to use alpha chymotrypsin to lyse large blood clots in the AC like it used to be done to break the zonules in the ICCE days? I liked the idea of using epinephrine to stop a second bleed and dilate the pupil at the same time.Air bubble in the AC after evacuating the hyphema will also work and in one of the videos , it was a learning to see the air bubble pushing out a small hyphema through the side port after the Phaco surgery.